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Usefulness of carcinoembryonic antigen monitoring despite normal preoperative values in node-positive colon cancer patients

  • Original Contributions
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Diseases of the Colon & Rectum

Abstract

PURPOSE: The aim of our study was to determine to what extent serial carcinoembryonic antigen (CEA) monitoring is helpful in detecting colorectal cancer recurrence in patients if their preoperative serum CEA is normal. Additional major objectives of this study were to correlate CEA immunohistochemical features of the primary tumor with serum CEA levels at the time of tumor recurrence in node-positive colorectal cancer patients with low preoperative CEA values. METHODS: One hundred fourteen node-positive colorectal cancer patients with preoperative serum CEA levels of <5.0 ng/ml undergoing clinically curative operations were studied. Primary tumors were evaluated for tissue CEA using the same monoclonal antibody as used for serum CEA determinations utilizing the avidin-biotin-peroxidase immunohistochemical technique. RESULTS: The exact preoperative serum CEA value did not correlate with tumor grade, immunohistochemical CEA intensity or pattern. In the 32 patients who developed recurrent cancer, the serum CEA at recurrence was greater than 5 ng/ml in 44 percent. All such patients had CEA present in their primary tumor. There was no correlation with the exact preoperative serum CEA, the intensity of the primary tissue CEA, or the localization of such CEA and subsequent serum elevation at recurrence. CONCLUSION: Serum CEA is a useful marker in the detection of recurrent colorectal cancer despite normal preoperative values.

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References

  1. Kohler JP, Simnonowitz D, Paloyan D. Pre-operative CEA level: a prognostic test in patients with colorectal carcinoma. Am Surg 1980;46:449–52.

    PubMed  CAS  Google Scholar 

  2. Wolmark N, Fisher B, Wieaund HS. The prognostic value of modifications of Dukes' C class of colorectal cancer: an analysis of the NASBP clinical trials. Ann Surg 1986;203:115–22. significance of carcinoembryonic antigen in colorectal carcinoma, serum levels before and after resection and before recurrence. Arch Surg 1991;126: 314–6.

    PubMed  CAS  Google Scholar 

  3. Martin EW Jr, Minton JP, Carey LC. CEA-directed second-look surgery in the asymptomatic patient after primary resection of colorectal cancer. Ann Surg 1985;202:310–17.

    Article  PubMed  Google Scholar 

  4. Goslin R, Steele G, MacIntyre J,et al. The use of pre-operative plasma CEA levels for the stratification of patients after curative resection of colorectal cancer. Ann Surg 1980;192:747–51.

    PubMed  CAS  Google Scholar 

  5. Wanebo JH, Stearns MW, Schwartz MK. Use CEA as an indicator of early recurrence and as a guide to a selected second-look procedure in patients with colorectal cancer. Ann Surg 1978;188:481–92.

    PubMed  CAS  Google Scholar 

  6. Goldenberg DM, Goldenberg H, Sharkey RM,et al. Imaging of colorectal carcinoma with radiolabeled antibodies. Semin Nucl Med 1989;19:262–81.

    PubMed  CAS  Google Scholar 

  7. Zeng ZS, Divgi CR, McDermott KC,et al. Radioimmunodetection of colorectal cancer. Perspect Colon Rectal Surg 1991;4:35–67.

    Google Scholar 

  8. Lind P, Lechner P, Arian-Schad K,et al. Anti-carcinoembryonic antigen immunoscintigraphy (technetium-99 m-monoclonal antibody BW 431/26) and serum CEA levels in patients with suspected primary and recurrent colorectal carcinoma. J Nucl Med 1991;32:1319–25.

    PubMed  CAS  Google Scholar 

  9. Gold P, Freeman SO. Specific carcinoembryonic antigens of the human digestive system. J Exp Med 1965;122:467–81.

    Article  PubMed  CAS  Google Scholar 

  10. Bordes M, Michiels R, Martin F. Detection by immunofluorescence of carcinoembryonic antigen in colonic carcinoma, other malignant or benign tumors and non-cancerous tissues. Digestion 1973;9:109–15.

    Article  Google Scholar 

  11. Crowson M, Hockey MS, Newman J,et al. An immunocytochemical study of carcinoembryonic antigen (CEA) expression in colorectal tumors and their metastases using a monoclonal antibody (abstr). Br J Surg 1984;71:376.

    Google Scholar 

  12. Goldenberg DM, Sharkey RM, Primus FJ. Immunocytochemical detection of carcinoembryonic antigen in conventional histopathology specimens. Cancer 1978;42:1546–53.

    PubMed  CAS  Google Scholar 

  13. Nakopoulou L, Zinozi M, Theodoropoulos G,et al. Carcinoembryonic antigen detection by immunocytochemical methods in carcinomas of the colon and stomach. Dis Colon Rectum 1983;26:269–74.

    PubMed  CAS  Google Scholar 

  14. Midiri G, Amanti C, Benedetti M,et al. CEA tissue staining in colorectal cancer patients. Cancer 1985;55:2624–29.

    PubMed  CAS  Google Scholar 

  15. Boyd CR, Bivens BA, Kashmire R,et al. Plasma CEA, tumor CEA, tumor histology. J Surg Oncol 1976;8:507–12.

    PubMed  CAS  Google Scholar 

  16. Page M, Dalifard I, Bertrand G. Immunostaining of colorectal cancer with monoclonal anti-CEA antibodies compared to serum and tumor CEA content. Anticancer Res 1986;6:893–96.

    PubMed  CAS  Google Scholar 

  17. Cunningham L, Stocking B, Halter SA,et al. Immunoperoxidase staining of carcinoembryonic antigen as a prognostic indicator in colorectal carcinoma. Dis Colon Rectum 1986;29:111–6.

    PubMed  CAS  Google Scholar 

  18. Goslin R, O'brien MJ, Steele G,et al. Correlation of plasma CEA and CEA tissue staining in poorly differentiated colorectal cancer. Am J Med 1981;71:246–53.

    Article  PubMed  CAS  Google Scholar 

  19. Denk H, Tappeiner G, Eckerstorfer R,et al. Carcinoembryonic antigen in gastrointestinal and extragastrointestinal tumors and its relationship to tumor cell differentiation. Int J Cancer 1972;10:262–72.

    PubMed  CAS  Google Scholar 

  20. Zamcheck N. The expanding field of colorectal cancer marker: CEA, the prototype. Cancer Bull 1981;33:141–51.

    Google Scholar 

  21. Hamada Y, Yamamura M, Hioki K,et al. Immuno-histochemical study of carcinoembryonic antigen in patients with colorectal cancer, correlation with plasma carcinoembryonic antigen levels. Cancer 1985;55:136–41.

    PubMed  CAS  Google Scholar 

  22. Nagura H, Tsutsumi Y, Shioda Y,et al. Immunohistochemistry of gastric carcinoma and associated disease: novel distribution of carcinoembryonic antigen and secretory component on the surface of gastric cancer cells. J Histochem Cytochem 1992; 31(Suppl 1A):193–8.

    Google Scholar 

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Authors and Affiliations

  1. Colorectal Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York

    Zhaoshi Zeng M.D. & Alfred M. Cohen M.D.

  2. Colorectal Service, Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York

    Carlos Urmacher M.D.

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  1. Zhaoshi Zeng M.D.
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  2. Alfred M. Cohen M.D.
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  3. Carlos Urmacher M.D.
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Zeng, Z., Cohen, A.M. & Urmacher, C. Usefulness of carcinoembryonic antigen monitoring despite normal preoperative values in node-positive colon cancer patients. Dis Colon Rectum 36, 1063–1068 (1993). https://doi.org/10.1007/BF02047301

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